(I/We) hereby certify that all the information contained in this application is true and complete to the best of my knowledge and (I/We) will comply with the terms and conditions under which the encroachment permit hereby applied for is issuedThe undersigned hereby makes application for a permit to do work outlined above, and if desired permit is issued, agrees to comply with all existing Ordinances of the City of St. Matthews and provisions of the Utility Policy of the Louisville Metro Department of Public Works regulating the use of public ways and the opening of streets, alley, sidewalk or highways, and to complete said work within the designated time state within the permit application. Surface and subsurface examination and investigation of the work site should be undertaken by the permittee prior to commencement of the work covered by this Permit.

In signing the application for the permit sought hereunder, (I/We) fully indemnify and hold harmless the City and all its employees, officials and representatives from any claim, damage or injury to a person or property, including damage to any City property, arising, or alleged to arise from any work related to the approved encroachment or work thereof. Further, (I/We) hereby certify that this indemnify and hold harmless agreement extends to the actions of any subcontractors (I/We) may use to complete the work. Finally, (I/We) hereby certify that the right of way will be restored to its pre-construction condition at the conclusion of the work.